The Effect of Framed Health Messages on Intention to Take Antivirals for Pandemic Influenza: A Vignette-Based Randomised Controlled Trial

Abstract

During the last influenza pandemic, adherence to antivirals was suboptimal. This study investigated the effect of manipulating the wording of written health messages on intentions to use antivirals as prophylaxis for pandemic influenza.

After reading a hypothetical pandemic flu scenario, adult UK residents (N = 216) were randomly allocated to one of the four conditions, defined by a 2 × 2 (agency assignment × attribute framing) factorial design. Each condition presented messages describing the pandemic flu using linguistic expressions that assigned agency to either humans (HA: human agency) or the virus itself (VA: virus agency), whilst describing the antivirals side effects in terms of the chances of either experiencing (NF: negative framing) or not experiencing side effects (PF: positive framing). Intentions to use the antivirals and potential mediating factors were measured.

Mean adherence intentions were high in all conditions with no significant differences between them. Higher perceived susceptibility, anticipated regret, self-efficacy, trust, and low response costs were found to predict adherence intentions. The VA messages increased perceived severity, the PF messages increased self-efficacy, whilst VA*PF affected response efficacy. The evidence did not support the hypothesis that the VA and PF framings can increase adherence intentions compared to the HA and NF messages, respectively.

Acknowledgments

Special thanks to Dr James Rubin and Dr Allison Wright (King’s College London) for their valuable feedback on the study design.

Authors’ contributions

DD drafted the manuscript. All authors read and approved the final manuscript.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Consent for publication

Not applicable

Disclosure statement

The authors declare that they have no competing interests.

Ethics, consent, and permissions

Ethical approval (Ref: LRS-15/16-2297) was granted by the Psychiatry, Nursing and Midwifery Research Ethics Panel at King’s College London (KCL). Given that this research used online surveys, no written consent was taken. However, all potential participants were provided with a detailed participant information sheet, which clearly stated that participation was entirely voluntary and that completing the research online would indicate their consent to participate. Trial registration: clinicaltrials.gov NCT03431012. 13/02/2018 retrospectively registered

Additional information

Funding

The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with Public Health England (PHE), in collaboration with the University of East Anglia and Newcastel University. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England.